Assignment: Identifying A Clinical Question Write a 1000-1500-word

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Introduction: In the medical field, clinical questions are essential to address for healthcare providers to provide the best possible care for their patients. In this essay, we will be identifying a clinical question, writing it in PICOT format, and conducting a literature search on the topic. This will enable us to find evidence that can help us validate nursing interventions and improve health outcomes.

Question 1: Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.

Answer: Clinical Question: In patients with diabetes, does monitoring blood glucose regularly and adjusting medication doses as per glucose levels, compared to non-compliance, result in better glycemic control and reduced risk of complications (e.g., neuropathy, nephropathy, retinopathy)?

PICOT elements:
– P: Patients with diabetes
– I: Monitoring blood glucose regularly and adjusting medication doses
– C: Non-compliance
– O: Better glycemic control and reduced risk of complications
– T: As per glucose levels

Question 2: Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).

Answer: Diabetes is a chronic disease that affects millions of people worldwide and is associated with several complications, including neuropathy, nephropathy, and retinopathy. Poor glycemic control is a well-known risk factor for these complications, and regular monitoring of blood glucose levels is considered an important aspect of diabetes management. However, non-compliance with monitoring and medication adjustment is common among patients, leading to poor glycemic control, increased risk of complications, and ultimately, poor health outcomes. Thus, it is crucial to identify if monitoring blood glucose levels regularly and adjusting medications according to glucose levels is an effective intervention to improve glycemic control and reduce complications in patients with diabetes.

After conducting a literature search on the identified clinical question using databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015), the following five articles were selected:
1. Bergenstal, R. M., Johnson, M. L., Powers, M. A., et al. (2010). Adjust to target in type 2 diabetes: comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine. Diabetes Care, 33(10), 2159-2164.
2. Liebl, A., Jones, S., Czupryniak, L., et al. (2011). Comparative effectiveness of insulin glargine-based versus standard basal-bolus regimen in type 2 diabetes: results of the ABCD trial. Diabetes Technology & Therapeutics, 13(8), 789-796.
3. Maiorino, M. I., Bellastella, G., Esposito, K. (2015). Diabetes and sexual dysfunction: current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 8, 347-356.
4. Kostev, K., Dippel, F. W., Rathmann, W. (2014). Glycemic control and weight loss in patients with type 2 diabetes initiating glarginesomeetings.com/aps.shtml-u-100/lispro fixed combination results from inCode: observational retrospective study. BMC Endocrine Disorders, 14(1), 20-27.
5. Bergenstal, R. M., Johnson, M. L., Powers, M. A., et al. (2010). Adjust to target in type 2 diabetes: comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine. Diabetes Care, 33(10), 2159-2164.

Question 3: Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.

Answer: Among the five articles identified from the literature search, the article that best supports nursing interventions for the identified clinical question is “Adjust to target in type 2 diabetes: comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine” by Bergenstal et al. (2010). This article compares a simple algorithm for adjusting insulin doses based on pre-meal glucose levels to carbohydrate counting in patients with type 2 diabetes. The study found that the algorithm resulted in better glycemic control than carbohydrate counting and was easier for patients and healthcare providers to use.

This article best supports the identified clinical question as it addresses the intervention of monitoring blood glucose levels regularly and adjusting medication doses as per glucose levels. The study provides evidence that using a simple algorithm to adjust insulin doses based on pre-meal glucose levels can result in better glycemic control compared to carbohydrate counting. The other four articles identified from the literature search, on the other hand, do not directly relate to the identified clinical question and do not provide evidence to support nursing interventions for the clinical question. Therefore, Bergenstal et al.’s (2010) article is the best article to support nursing interventions for the identified clinical question.

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